Ðe ɖeɖi tea ŋuwò eye taɖuame koe nɔa ŋuwò ɣeaɖewoɣia? Alo ɖe nèsena le ɖokuiwò me ɣeaɖewoɣi be yeƒe ŋutigbalẽ le ɣie vie, eye wò ŋku ƒe ɣiwo hã le ɣiea? Esia ate ŋu anye nusi do ƒome kple wò ʋumenugbagbevi dzĩwo, si nye lãmenugbagbevi vevitɔwo dometɔ ɖeka le wò ʋu me. Egbea míele nu ƒom tso nɔnɔme aɖe si woyɔna be hemolysis , si nye esime ʋumenugbagbevi dzĩwo gblẽna eye wogblẽna kaba. Mègatsi dzi o, ele vevie be nànya esia.
Nuka tututue nye ʋumenugbagbeviɣidɔ?
Kpuie ko la, ʋumenugbagbeviɣidɔ nye ʋumenugbagbevi dzĩ siwo le míaƒe ŋutilã me tsɔtsrɔ̃ . Ènyaa, ʋumenugbagbevi dzĩ siawo le abe dɔwɔla sue siwo le míaƒe ʋu me ene. Woawoe xɔa ɔksidzin tso lãkusi me ne míele gbɔgbɔm hetsɔnɛ yia lãmenugbagbevi kple lãmenugbagbevi bubu ɖesiaɖe si le ŋutilãa me gbɔ. Ele abe gas-go aɖe tsɔtsɔ va aƒeme ene. Eyata, míaƒe ŋutilã zãa ɔksidzin sia tsɔ wɔa ŋusẽ si wòhiã. Azɔ hã, ʋumenugbagbevi dzĩ siawo ke kpena ɖe mía ŋu míetsɔa ya si nye carbon dioxide si míedi o si ƒoa ƒu ɖe míaƒe ŋutilã me la yia lãkusiwo me eye míegbɔnɛ.
Zi geɖe la, míaƒe ŋutilã tsrɔ̃a ʋumenugbagbevi dzĩ xoxowo alo esiwo gbɔdzɔ ɣesiaɣi eye wòtsɔa ʋumenugbagbevi dzĩ yeye siwo le lãmesẽ me ɖoa wo teƒe. Esia le abe xoxowo ɖeɖeɖa kple yeyewo ɖeɖeɖa ene. Tsɔtsrɔ̃ kple ewɔwɔ ƒe tsatsam sia tae ʋumenugbagbevi dzĩwo ƒe agbɔsɔsɔ si sɔ nɔa míaƒe ŋutilã me ɣesiaɣi ɖo.
Gake ɣeaɖewoɣi la, ʋumenugbagbevi dzĩ siawo dzea gbagbã gɔme kaba, si fia be wodzea gbagbã kabakaba akpa . Esia ate ŋu adzɔ hafi míaƒe ŋutilã nakpɔ ɣeyiɣi awɔ lãmenugbagbevi yeyewo atsɔ aɖo doa me. Woyɔa ʋumenugbagbevi dzĩwo ƒe tsɔtsrɔ̃ kabakaba sia be ʋumenugbagbeviɣidɔ. Ne ʋumenugbagbevi dzĩwo ƒe xexlẽme dzi ɖe kpɔtɔ ŋutɔ le ʋumenugbagbeviɣi sia ta la, míeyɔa nɔnɔme ma be ʋusɔgbɔdɔ , alo ʋusɔgbɔdɔ.
Nukatae wogblẽa ʋumenugbagbevi dzĩwo le mɔ sia nu?
Zi geɖe la, ʋumenugbagbevi dzĩ aɖe nɔa agbe abe ŋkeke 120 ene. Le ɣeyiɣi sia ƒe nuwuwu ne lãmenugbagbevi mawo tsi la, woɖea dzesi tɔxɛ aɖewo ɖe go. Dzesi siawo nana aɖuɖɔ (si le ƒodo ƒe miame) si le míaƒe ŋutilã me tsrɔ̃a lãmenugbagbevi xoxo siawo le ɖoɖo nu. Abe alesi míeɖea xɔmenuwo xoxo siwo gbã le míaƒe aƒea me ɖa ene.
Wowɔa ʋumenugbagbevi dzĩ yeyewo le míaƒe ƒuwo ƒe akpa si le abe ƒumeŋuɖui ene si woyɔna be ƒumeŋuɖui me . Emegbe woɖea ʋumenugbagbevi dzĩ yeye siwo wowɔ le ƒumeŋuɖui sia me la dona ɖe ʋua me.
Gake ɣeaɖewoɣi la, ʋumenugbagbevi dzĩ ƒe nɔnɔme alo eƒe wɔwɔme ƒe gbɔdzɔgbɔdzɔ ate ŋu ana eƒe agbenɔƒe nadidi. Alo, gotagomenuwo ate ŋu agblẽ nu le ʋumenugbagbevi dzĩwo ŋu eye woaku hafi ŋutilãa nate ŋu awɔ lãmenugbagbevi yeyewo.
Nukawoe nye ʋumenugbagbeviɣidɔ ƒomevi veviwo?
Woate ŋu ama ʋumenugbagbeviɣidɔ ɖe hatsotso vevi eve me. Ŋkɔ siawo fia afisi ʋumenugbagbevi dzĩwo tsrɔ̃na le.
1. Extravascular hemolysis: Esia nye esime ʋumenugbagbevi dzĩwo tsrɔ̃na le míaƒe ʋukawo godo (i.e., ʋukawo, ʋukawo, kple ʋukawo). Zi geɖe la, esia dzɔna le dɔgboa me . Ne ʋu to aɖuɖɔtoea me la, ʋumenugbagbevi ɣi ƒomevi tɔxɛ aɖe si woyɔna be macrophages (siawo le abe míaƒe ŋutilã ƒe dedienɔnɔdzikpɔlawo ene) dea dzesi ʋumenugbagbevi dzĩ xoxo siwo gblẽ eye wogblẽa wo dome.
2. Ʋukawo me ʋu ƒe sisi: Le esia me la, ʋumenugbagbevi dzĩwo tsrɔ̃na le ʋukawo me. Ne wotsrɔ̃ wo la, lãmenugbagbevi mawo ƒe akpa aɖewo zɔa mɔ toa ŋutilã bliboa me kple míaƒe ʋu.
Nukawoe hea ʋumenugbagbeviɣidɔ vɛ?
Menye nu ɖeka koe nana ʋu sina toa ʋu me o, ke boŋ nu geɖe siwo ate ŋu ana wòadzɔ. Mina míalé ŋku ɖe eŋu tsitotsito vie.
1. Gblẽƒe siwo le ʋumenugbagbevi dzĩwo ŋutɔ ŋu
Ɣeaɖewoɣi la, ne ʋumenugbagbevi dzĩ aɖe ƒe nɔnɔme alo eƒe wɔwɔme mesɔ o alo nu gblẽ le eŋu la, woate ŋu atsrɔ̃ lãmenugbagbevi ma kaba. Zi geɖe la, dɔléle aɖewo siwo wodzina, alo domenyiŋusẽfianu, gbɔe nɔnɔme madeamedzi mawo tsona .
- Hemoglobin ƒe malikenyenye: Hemoglobin nye protein si kpena ɖe ame ŋu wòtsɔa oxygen yia ʋumenugbagbevi dzĩwo me. Nɔnɔme siwo hea malikenyenye sia vɛ dometɔ aɖewoe nye ʋusɔgbɔdɔ si woyɔna be sickle cell anemia (afisi ʋumenugbagbevi dzĩwo va zua sickle ƒe nɔnɔme le) kple thalassemia .
- Enzyme ƒe anyimanɔmanɔ: Nɔnɔme sia ate ŋu adzɔ hã ne enzyme aɖewo siwo hiã na ʋumenugbagbevi dzĩwo ƒe dɔwɔwɔ meli o. Kpɔɖeŋu aɖewoe nye G6PD ƒe anyimanɔmanɔ kple pyruvate kinase ƒe anyimanɔmanɔ .
- Lãmetsiŋusẽ ƒe gbɔdzɔgbɔdzɔ: Nɔnɔme siwo me nu gblẽ le ʋumenugbagbevi dzĩwo ƒe gotagome nutsyɔnu, si nye lãmenugbagbeviwo ƒe lãkusi ŋu. Kpɔɖeŋu aɖewoe nye domenyiŋusẽfianu ƒe spherocytosis ( lãmenugbagbeviwo zua goglo) kple domenyinyi ƒe elliptocytosis (lãmenugbagbeviwo va didi).
2. Dɔléle siwo do ƒome kple dɔlélenutsiŋutete
Ɣeaɖewoɣi la, mía ŋutɔwo ƒe dɔlélenutsiŋutete (si kpɔa mía ta tso dɔléle me) dzea mía ŋutɔwo míaƒe ʋumenugbagbevi dzĩwo dzi dzedze gɔme vodadatɔe. Woyɔa esia be autoimmune hemolytic anemia (AIHA) . Esia nye nɔnɔme si mebɔ o. Esia ƒomeviwo hã li:
- Vuvɔ ƒe agglutinin dɔléle ( dzesiawo nu sẽna ɖe edzi ne wodo go vuvɔ) .
- Aglutinin ƒe dɔléle si me dzoxɔxɔ le
Nɔnɔme bubu aɖewo siwo ate ŋu ahe AIHA vɛ dometɔ aɖewoe nye Mycoplasma pneumonia , lymphoma , ʋumenugbagbeviɣidɔ (esiawo nye kansa ƒomeviwo), lupus, kple ƒunukpeƒetetedɔ (esiawo hã nye dɔléle siwo dɔlélenutsiŋutete hena vɛ).
Nɔnɔme bubu siwo menye dɔlélenutsiŋutete o:
- Ʋumenugbagbeviɣidɔ si nye paroxysmal vuvɔ
- Zã me ʋumenugbagbeviɣidɔ si woyɔna be paroxysmal hemoglobinuria
3. Dɔlékuiwo
Dɔlékuiwo, dɔlékuiwo, kple dɔlékui aɖewo siwo gena ɖe míaƒe ŋutilã me ate ŋu agblẽ nu le míaƒe ʋumenugbagbevi dzĩwo ŋu, eye woagblẽ wo hafi woate ŋu aɖɔli wo. Esia ƒe kpɔɖeŋu nyui aɖee nye asrãdɔ . Dɔlékui si hea asrã vɛ la dzea ʋumenugbagbevi dzĩwo dzi tẽ.
Nu bubu siwo hea dɔlélea vɛ:
- Babesiosis ƒe dɔléle
- Carrion ƒe dɔlélea
- Rocky Mountain ƒe teƒeteƒewo nye dzoxɔxɔ
- Haemophilus ƒe dzamezã
- Amegbetɔ ƒe dɔlélenutsiŋutete ƒe dɔlékui (HIV) .
4. Atike aɖewo
Atike aɖewo siwo míenona hã ate ŋu aʋã míaƒe dɔlélenutsiŋutete be wòadze ʋumenugbagbevi dzĩwo dzi eye wòatsrɔ̃ wo kaba hã, togbɔ be ƒã ŋutɔ hã. Woyɔa esia be dɔlélenutsiŋutete ƒe ʋusɔgbɔdɔ si atikewo hena vɛ (DIHA) . Esia mebɔ kura o.
Atike aɖewo siwo ate ŋu ana ʋu natso:
- Acetaminophen ( atike si woyɔna be paracetamol ) .
- Cephalosporin dɔlékuiwutike aɖewo
- Clopidogrel si nye atike si woyɔna be Clopidogrel
- Dapsone ƒe ŋkɔ
- Heparin ƒe atike
- Levodopa ƒe dɔléle
- Levofloxacin ƒe atike si wozãna
- Methyldopa ƒe dɔlékuiwutike
- Nitrofurantoin si woyɔna be nitrofurantoin
- Penicillin ƒe atike
- Phenazopyridine ƒe atike
- Quinidine ƒe atike
- Quinine si wotsɔna ƒoa ƒui
- Rifampin ƒe ŋkɔ
- Sulfonamide aɖewo
Vevietɔ: Mègana atike siwo woŋlɔ ɖi sia navɔ̃ o. Ƒã hafi atike siawo nana ʋu sina toa ʋu me. Ne ɖɔkta aɖe ŋlɔ atike siawo na wò la, wɔ ɖe woƒe mɔfiamewo dzi. Ne nya aɖe le asiwò la, ƒo nu kple wò ɖɔkta.
5. Kuxi siwo dona tso fufɔɣi
Kuxi aɖewo siwo doa mo ɖa le fufɔɣi hã ate ŋu ana ʋumenugbagbevi dzĩwo nagbã kaba.
- HELLP ƒe dɔlélea
- Preeclampsia ƒe dɔléle
- Eclampsia ƒe dɔléle
Esi wònye be esiawo nye nɔnɔme sesẽ siwo ate ŋu ado mo ɖa le fufɔɣi ta la, ele vevie be nàdi atikewɔlawo ƒe aɖaŋuɖoɖo enumake ne dzesiwo dze.
6. Atikewɔnuwo kple atikewɔwɔwo
Esia hã mebɔ o. Ʋumenugbagbeviɣidɔ ate ŋu adzɔ ne wotsɔ atikewɔmɔ̃ aɖewo de ŋutilãa me, alo le atikewɔwɔ aɖewo me, vaseɖe esime ŋutilãa natrɔ ɖe wo ŋu.
- Ʋumenugbagbeviɣidɔ na ayiku dɔnɔwo
- Mɔ̃ si wotsɔna toa dzi kple lãkusi (si wozãna le amekoko gãwo me) .
- Dzi ƒe ʋukawo ɖɔliɖɔli
- Mɔ̃ bubu siwo wozãna le nɔnɔmewo abe dzi ƒe dɔmawɔmawɔ nyuie ene me, le kpɔɖeŋu me , intra-aortic balloon pumps kple Impella devices .
- Ʋudodo (abe ne wodo ʋu si mewɔ ɖeka o ene) .
7. Aɖi kple aɖinuwo
Aɖi aɖewo, ne woɖu wo la, ate ŋu agblẽ nu le ʋumenugbagbevi dzĩwo ŋu eye woana ʋu natsi.
- Arsenic (Arsenic) si wotsɔna ƒoa ƒui
- Akɔbli ( ne woɖui wògbɔ eme) .
- Nɔ ŋgɔ
- Arsine ( ya si me aɖi le) .
- Stibine ( ya si me aɖi le) .
- Da ƒe aɖi
Tsɔ kpe ɖe eŋu la, nɔnɔme ɖesiaɖe si me aɖuɖɔtoea wɔa dɔ fũu akpa (hypersplenism) hã ate ŋu ana ʋu nado. Nenema ke ʋu ƒe sisi si nu sẽ akpa ate ŋu ana ʋumenugbagbevi dzĩwo nagbã esi ʋu le zɔzɔm to ʋukawo me kabakaba akpa.
Nukawoe nye ʋumenugbagbeviɣidɔ ƒe dzesiwo?
Dzesiawo nɔ te ɖe alesi wò ʋumenugbagbevi dzĩwo ƒe xexlẽme le sue dzi. Ne wò ʋumenugbagbevi dzĩwo ƒe xexlẽme meɖiɖi akpa o la, ɖewohĩ màkpɔ dzesi aɖeke o. Zi geɖe la, dzesiawo dzena le esi ŋutilãa ƒe lãmenugbagbeviwo kple lãkusiwo mele oxygen si sɔ xɔm o ta le esi ʋumenugbagbevi dzĩwo ƒe xexlẽme mede o ta.
Dzesi siwo bɔ:
- Ɖeɖiteameŋu
- Taɖuame
- Ŋutilã si ƒe ŋutigbalẽ le ɣie
- Dzi ƒe tsotso / dzi ƒe tsotso
- Yagbɔgbɔ kpui / gbɔgbɔtsixetsixe
- Ŋutilã ƒe ɣie kple ŋku ƒe ɣie (Jaundice) (Esia tsoa bilirubin, si nye nusi dona ne ʋumenugbagbevi dzĩwo gblẽ, ƒe ƒuƒoƒo ɖe ʋua me gbɔ)
- Aɖuɖɔtoe si lolo / ƒunukpeƒetetedɔ
Dzesi aɖewo ate ŋu ato vovo le nɔnɔme tɔxɛ si na ʋumenugbagbeviɣidɔa tso nu. Le kpɔɖeŋu me, ame aɖe si ŋu agglutinin ƒe dɔléle si nye vuvɔ le ate ŋu akpɔ ʋu ƒe sisi ɖe asibidɛwo kple afɔbidɛwo ŋu dzi ɖeɖe kpɔtɔ, si ana wòazu blɔ eye wòazu lãmetutudɔ (Raynaud ƒe nudzɔdzɔ) .
Dodokpɔ kawoe wowɔna tsɔ nyaa ne kuxi aɖewo do ƒome kple ʋumenugbagbeviɣidɔ?
Ðɔkta aɖe wò ʋu aɖe eye wòawɔ dodokpɔ geɖe atsɔ akpɔe ɖa be ʋumenugbagbevi dzĩ siwo ɖiɖi la tso ʋumenugbagbeviɣidɔ gbɔ hã.
- Ʋu ƒe xexlẽme blibo (CBC): Esia ate ŋu ana nànya nu geɖe tso lãmenugbagbevi ƒomevi siwo katã le wò ʋu me ŋu, vevietɔ wò ʋumenugbagbevi dzĩwo. Ate ŋu alé ŋku ɖe nuwo abe wò ʋumenugbagbevi dzĩ ƒe agbɔsɔsɔ kple teƒe agbɔsɔsɔme si wò ʋumenugbagbevi dzĩwo xɔna le wò ʋu me (hematocrit) ene ŋu.
- Reticulocyte ƒe xexlẽme: Esia nye CBC dodokpɔa ƒe akpa aɖe. Reticulocytes nye ʋumenugbagbevi dzĩ siwo wowɔ yeyee siwo metsi bliboe haɖe o. Ne ʋumenugbagbeviɣidɔ li la, reticulocyte ƒe xexlẽme ate ŋu adzi ɖe edzi esime ŋutilãa le lãmenugbagbevi yeyewo wɔm kabakaba be woaxɔ ɖe esiwo tsrɔ̃ teƒe.
- Ʋu si wotsɔna ƒoa ʋu le lãme na ame: Dodokpɔ sia ate ŋu akpɔe ɖa be wò ʋumenugbagbeviɣiwo ƒe nɔnɔme kple woƒe lolome mesɔ o hã. Anɔ eme be lãmenugbagbevi siwo ƒe nɔnɔme mesɔ o la tsrɔ̃na kabakaba.
- Lactate dehydrogenase (LDH): LDH nye enzyme si le ʋumenugbagbevi dzĩwo me. Ne ʋumenugbagbevi dzĩwo me gblẽ kabakaba wu alesi wòle dzɔdzɔmee la, LDH ƒe agbɔsɔsɔ si le ʋua me ate ŋu adzi ɖe edzi.
- Haptoglobin dodokpɔ: Haptoglobin nye protein si do ƒome kple hemoglobin. Ne ʋumenugbagbevi dzĩwo gbã (abe alesi wòle le ʋumenugbagbeviɣidɔ me ene) la, ʋumenugbagbeviɣi gbogbo aɖewo dona ɖe ʋua me. Emegbe haptoglobin ƒe agbɔsɔsɔ dzi ɖena kpɔtɔna.
- Bilirubin si wometsɔ ƒo ƒui o: Wowɔa bilirubin ne hemoglobin si le ʋumenugbagbevi dzĩwo me gblẽ. Bilirubin ƒe agbɔsɔsɔ si sɔ gbɔ ɖe ʋua me ɖenɛ fiana be ʋumenugbagbevi dzĩ gbogbo aɖewo le gbegblẽm (esiae hea ʋumenugbagbeviɣidɔ vɛ).
- Coombs dodokpɔ tẽ: Dodokpɔ sia ate ŋu ade dzesii nenye be dɔlékuiwutike siwo léna ɖe wò ʋumenugbagbevi dzĩwo ŋu eye wogblẽa wo kabakaba (esia ate ŋu akpe ɖe ŋuwò nànya nɔnɔmewo abe AIHA ene).
Tsɔ kpe ɖe eŋu la, ɖɔkta ate ŋu awɔ aɖuɖɔtoemedɔdada atsɔ akpɔe ɖa be ʋu kple bilirubin le wò aɖuɖɔ me hã, si ate ŋu anye nɔnɔme aɖe si woyɔna be ʋusɔgbɔdɔ si me ʋu sina tona ƒe dzesiwo.
Aleke wodaa ʋumenugbagbeviɣidɔ?
Wò atikewɔwɔ anɔ te ɖe nusi gbɔ wò ʋumenugbagbeviɣidɔ tso kple alesi wò dzesiawo nu sẽe dzi. Atikewɔwɔ ƒe tiatia aɖewo ate ŋu anye vitaminwo, atikewo, amekoko, kple ʋudodo.
Nu vevitɔe nye be nàƒo nu kple wò ɖɔkta tso atikewɔwɔ si nyo na wò ŋu, le dɔléle si nèkpɔ nu.
Míaƒe ŋutilã le agbagba dzem ɣesiaɣi be yealé ʋumenugbagbevi dzĩwo ƒe xexlẽme si sɔ la me ɖe asi. Gake dɔlékuiwo, dɔléle siwo wodzina, kple gotagome ŋusẽkpɔɖeamedziwo ate ŋu agblẽ dɔ sia me eye wòana ʋumenugbagbevi dzĩwo natsrɔ̃ kaba akpa. Esia wɔe be ʋumenugbagbevi dzĩwo dzi aɖe akpɔtɔ, si ana ʋusɔgbɔdɔ si nana ʋu sina toa ʋu me nadze ame dzi.
Gake nya nyuiae nye be woate ŋu ada nu geɖe siwo hea ʋumenugbagbeviɣidɔ vɛ. Ne ɖɔkta nya nya nusi gbɔ wò ʋumenugbagbeviɣidɔ tso ko la, aŋlɔ atike siwo akpe ɖe ŋuwò nàna wò ʋumenugbagbevi dzĩwo ƒe xexlẽme nagaɖo nɔnɔme nyuitɔ me.
Nu vevi siwo dzi wòle be woaɖo ŋkui (Take-Home Message) .
- Ʋumenugbagbeviɣidɔ nye ʋumenugbagbevi dzĩwo tsɔtsrɔ̃ kaba.
- Esia ate ŋu ahe dzesiwo abe ɖeɖiteameŋu si gbɔ eme, taɖuame, kple ŋutigbalẽ ƒe ɣie (jaundice) vɛ .
- Nu geɖewo ate ŋu ahe esia vɛ; ʋumenugbagbevi dzĩwo ŋutɔ ƒe gbɔdzɔgbɔdzɔ, dɔlélenutsiŋutete ƒe kuxiwo, dɔlékuiwo, atike aɖewo, kuxi siwo dona tso fufɔɣi, kple bubuwo.
- Ne dzesi siawo le ŋuwò la, di atikewɔlawo ƒe aɖaŋuɖoɖo godoo .
- Ʋudodokpɔ ate ŋu akpe ɖe ame ŋu wòanya nusi gbɔ wòtso eye wòana atike si sɔ.
- Woate ŋu ada nu geɖe siwo gbɔ wòtsona be ʋumenugbagbevi dzĩwo ƒe agbɔsɔsɔ nagaɖo wo me. Eyata ele vevie be màgatsi dzodzodzoe ahadi atikewɔlawo ƒe mɔfiame nyuitɔ o.
Mele mɔ kpɔm be nyatakaka sia aɖe vi na wò. Nɔ lãmesẽ me!
` Ʋumenugbagbeviɣidɔ, ʋumenugbagbevi dzĩwo, ʋusɔgbɔdɔ, dɔgbo, ƒumeŋuɖui, ʋuʋudedi, ʋudodokpɔ
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